Hepatitis C Treatment Makes Economic Sense

Research by the
Christchurch School of Medicine and Health Sciences has
shown that methadone maintenance therapy for injecting drug
users saves lives, and it is also cost-effective to treat
their Hepatitis C virus.

The Otago University research
team investigated both Maori and non-Maori drug users who
are on methadone maintenance and found that excess mortality
from drug overdoses was reduced by 75% amongst people who
are on methadone maintenance. 98% of the participants
stopped injecting drugs, reported large improvements in
their health and also reductions in drug-related crime.

Although 84% of the estimated 19,000 injecting drug users
in N.Z. have Hepatitis C, few are receiving treatment for
the virus. The total number with the virus in NZ is
estimated at 30,000 people, but that is expected to double
by 2010. End stage Hepatitis C can be fatal, has major
effects on the liver and other serious health impacts. There
is evidence that large numbers of drug users actually want
treatment for Hepatitis C, but don’t get it. Meanwhile there
are also long waiting lists for methadone maintenance
treatment (MMT).

Lead investigator Dr Ian Sheerin from
the Department of Public Health and General Practice at the
School says there is an urgent need for policies aimed to
control the spread of this debilitating virus. These include
needle exchanges, education about risky behaviours, blood
awareness, access to drug and alcohol services, as well as
Hepatitis C treatment.

“The size of the health problem is
not being matched by government investment in communicable
disease control. The policy documents say the right things,
but the commitment has not been made to address the issue
adequately.”

“However, the government made an important
step in 2004 when it funded combination medication for
Hepatitis C. Research shows this treatment is effective.
For some of types of Hep C, combination therapy has been
shown to cure 80% of cases. “

Dr Sheerin says the key is
that although Hepatitis C medication is expensive, the
courses are short and will prevent 39% of future health
costs. He says if nothing is done, then two things are
likely to happen. Hepatitis C will spread, not only amongst
drug users, but also in wider N.Z. society. This will have
rapidly escalating health and social welfare costs as
sufferers become more debilitated, need constant health
care, and their livers fail.

These costs have already been
estimated to rise between to $166 and $400 million in the
next 30 years unless adequate treatment and disease control
is provided. It costs more than $120,000 for a liver
transplant and there is a major shortage of liver donors. It
makes more sense to invest in Hepatitis C treatment at an
early stage, than wait until people need a liver
transplant.

“There’s a tendency in N.Z. to see this as
just a drug users’ problem, therefore why worry. That’s
ignoring the fact that Hepatitis C is a growing and
expensive health issue, which won’t go away,” says Dr
Sheerin. ” The existence of a large pool of untreated
infectious disease is a potential threat to everyone”.

Because, the Hepatitis C virus is slow in its
progression, there has been limited recognition of this
public health issue and New Zealand is currently losing
ground by about 1300 new infections every year.

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